Flexible Spending Accounts

View or Print FSA Summary Plan Description (pdf)
View or Print FSA Employee Election Form (pdf)
View or Print FSA Reimbursement Form (pdf)
View or Print FSA Change of Election Form (pdf)
Information on Over-the-Counter Medications
Eligible FSA Expenses
FlexSave Website

PURPOSE OF THE PLAN
The Flexible Spending Account is designed to cover specific out-of-pocket health and dependent care expenses you anticipate during the course of the Plan Year. The Flexible Spending Account allows you to use pretax dollars to pay for health expenses not covered by insurance. Expenses payable through the Flexible Spending Account include charges for contact lenses, eyeglasses, dental expenses, plus any deductibles and co-payments. In fact, any medical, dental, hearing or vision expenses that would otherwise qualify as a deduction on your income tax return will qualify for reimbursement, as long as the expense is not paid by another benefit plan. You may also pay for dependent care expenses.

HOW TO PARTICIPATE
In order to participate in the Plan you must file a Flexible Spending Accounts Election Form each year with the Compensation and Benefits Administrator during the open enrollment period. This form will be distributed to each eligible employee with their open enrollment packet. If you do not complete the form and return it to the Compensation and Benefits Administrator prior to the date required, you will not be eligible to become a participant again until January 1st of the next Plan Year, unless there is a change of family status during the year that qualifies you to participate.

For more information on the Flexible Spending Accounts, access the links above or call Susan Praski at x20503.